Daily Archives: April 24, 2017

My 88 year old husband has just been diagnosed with impaired kidney function (raised creatinine level on blood/urine testing). He has been advised that he needs a referral to a Nephrologist but there is a delay in this happening. In the meantime, he is suffering attacks of diarrhea on most days. I am currently modifying his diet in line with the advice on your website but, in the meantime, would you consider his diarrhea is related to his kidney impairment or should we seek urgent advice regarding this? He is losing weight, muscle, tone and strength too. Multiple myeloma has been ruled out by the Oncologists. Many thanks, in advance, for any advice you can give me whilst waiting for his referral.

Diarrhea is sometimes seen in late stage chronic kidney disease (CKD), but it not a typical finding in earlier stage chronic kidney disease.  Diarrhea can lead to dehydration which can make CKD worse and may lead to acute kidney injury … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments

An 83 male diabetic on hemodialysis for 7 yrs wants to discontinue treatment for reasons other than medical. No family, no income, cannot do without support. He cannot stand up on his own due to balance problems. Wants to discontinue HD. Can expect to stay alive for how long after stopping HD? Do not want suffering. Can you advise?

If someone stops dialysis after being on dialysis for seven years, it is unlikely that he will live for very long.  In most studies, patients who stop dialysis after being dependent on dialysis for 7 years will die within two … Continue reading

Posted in Ask the Doctor, Dialysis, End of Life Issues, Kidney Failure, Kidney-Related Health Questions

I am taking blood thinners for a clot in my leg. I have stage 3 kidney disease. What are the risk?

Patients with Stage 3 chronic kidney disease (CKD) can take blood thinners but they should be carefully monitored with blood testing and monitored for bleeding.  Most blood thinners are approved for use in Stage 3 CKD.  You should discuss your … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Function, Symptoms and Side Effects, Treatments

Hi, the patient has pain on her back, got done many tests and finally went for biopsy test, below is the test report. The doctor said nothing to worry just control blood pressure and stress and use less salt in food. But I consulted few other doctors, they said it is benign condition and can lead to kidney disease after 10 or 20 years but it is rare. It is a chronic kidney condition and has no treatment. Maybe after 20yrs, if unlucky can lead to end stage kidney disease. Another doctor says might the kidney have only 10yrs of life. Histopathology Report Clinical Data: Patient has microscopic hematuria, Negative family history. Specimen: A Light microscopy in formaldehyde. B. immunofluorescence in Michel’s medium. Diagnosis: IgA nephropathy with mesangial proliferation. Oxford classification score (M1E0SIT0). Interstitial fibrosis and tubular atrophy constitutes 20% No activity and mild chronicity Description: H&E, PAS, and trichrome stains. The biopsy consists of renal cortex containing 10 glomeruli. Seven glomeruli show segmental mesangial hypercelluarity (M1), without endocapillary proliferative lesion ( no celluar cresentsand no fibrinoid necrosis) (E0). Segmental sclerosis and adhesions to Bowmans capsule is seen in one glomerulus. (S1), no globally sclerotic glomeruli is seen. Thrichrome stains demonstrate segmental small mesangial red deposits. Blood vessels show mild degree of arteriolosclerosis. Interstitial fibrosis and tubular atrophy involves 20%of the cortex (T0) Immunofluorescence Microscopy (IF): Insufficien, renal medulla only. If stain performed on paraffin embedded tissue and show a cortex with 7 glomeruli. IgG: Glomeruli, negative. Tubules, 1+protein resorption droplets. IgA: Glomeruli 3+ granular mesangial staining. Tubules, negative, IgM: Glomeruli negative, Tubules, negative. C3: Glomeruli negative. Tubule: negative. C1q: Glomeruli, negative Patient Details : Female 26. Please give a Good Opinion on this report. I’m so confused and lot worried.

IgA nephropathy is a relatively common type of glomerulonephritis and has a variable course.  Some patients have only blood in the urine.  Others have protein and blood in the urine.  I am unable to give a prognosis without performing a … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diet/Nutrition, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Laboratory Testing, Treatments

After removal of stone from my left kidney naturally, I observed frequent drops of pus. I consulted with kidney specialists at SIUT Karachi Pakistan. They, after a series of tests declared that my left kidney has got infection, according to report, Daie Cell observed 0.3%, Tissues 0.2%, Creatinine 2.9, Pus18%, Platelets in blood reduced to 2200, Ultrasound revealed that left kidney collapsed by 0.3 cm. I am feeling pain and pus+ blood mixed drops are continuously discharging. The tests also revealed the presence of infection in cum-discharge. Doctors suggests two options to me. One to immediately remove this infected kidney, the body will be maintained on one kidney which is healthy. Second to undergo Laser Cystoscopic Surgery, in which infected part of your kidney will be cut-cleaned and cured for infection, the option being not available in Pakistan. I was advised to go UAE for this operation. My question to this worthy forum is to suggest me if the treatment of infected kidney is better option or the simply removal of kidney is good one. I am in doubt if this infection may re-occur even after having Laser Surgery..? An early reply is appreciated, please.

The question that you ask is a urological question.  I am a nephrologist and have no expertise in surgery or surgical treatment of kidney disease.  I suggest that you consult with your urologist, who is a kidney surgeon. If you … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Treatments, Urological Issues

What happens to CKD patients who can’t have dialysis or a kidney transplant because of a high risk of bleeding during surgery? What do they do?

I do not understand the bleeding problem.  In most cases, bleeding can be controlled with treatment.  In some cases, major surgery, such as transplant surgery may not be possible, but dialysis should still be possible.  I suggest you ask for … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Dialysis, Kidney-Related Health Questions, Nephrologist, Transplantation

I am 78 years old and just had my 6 months physical. I looked on the portal and has stage 3 chronic kidney disease that my doctor never told or talked about it. I called 2 times for explanation. The first call I got a assistant that told me that was all before so I called again and they will not call me back. I just want an explanation for whats wrong. Do I need medication or what or a new doctor?

I am unable to provide a specific diagnosis or recommend a treatment based on the information that you provide.  I suggest you make another appointment with your physician and discuss your concerns at the appointment.  

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects

My daddy is 74 yrs. old and almost almost 300 pounds. He has diabetes Type 2, COPD, congestive heart failure and has recently had pneumonia which caused a ton of fluid on his lungs. The Lasix used to help with the fluid is causing kidney failure. Is dialysis reasonable for a quality life?

The decision to start dialysis must be made by your father and a nephrologist based on the his ability to tolerate the treatment and the goals for treatment.  Your father should discuss his desires and wishes with his nephrologist and … Continue reading

Posted in Ask the Doctor, Diabetes, Dialysis, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Medication and Kidney Disease, Nephrologist, Treatments

There are 2 nephrologists in this area. They have a tendency to not take selected patients that need dialysis. Patients that go without dialysis would not survive. IS THAT LEGAL? These doctors are the only nephrologists in town.

A physician can chose to treat or not treat a patient depending on the services they have available.  You may have to consult with a nephrologist outside of the immediate area to get care that is not provided in your … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney Failure, Kidney-Related Health Questions, Laboratory Testing, Treatments

My mother is SLE patient since 92 and also diabetic heart patient since 2011. Recently she was diagnosed with pneumonia , at the moment her lungs are clear. She was brought in hospital in state of emergency. During her stay her creatinine became 3.1 and she was on insulin. After taking med dytor and nephrosave her creatinine is 1.6. Now should she continue with dytor and nephrosave? And also should she continue with insulin or get back to oral med glypizide 1000mg and diamcron 120mg?

I cannot recommend medical treatment without performing a complete history and physical examination.  I suggest that you follow the advice of the doctors who are caring for your mother.  They will have the complete information about her current health and … Continue reading

Posted in Ask the Doctor, Diabetes, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments